Hospital Hints

[Barry]

Since we've got so many seasoned veterans around here, thought it might be a good idea to begin a thread of helpful hints for hospital stays. Here's some stuff I picked up:

1. Take a small AM/FM portable radio with an earphone so you aren't stuck with nothing but TV.

2. Stop by the library on your way to the hospital and pick up a couple of books that look good. Pick up a couple, because you'll invariably find that one is a dud.

3. Befriend the housekeeping staff or find out where they stash the linens and get yourself a robe. Been in three hospitals, all three had robes, none of the three offered me one. Having a robe to wear over your hospital gown does much for the dignity factor.

4. Pay very close attention to what your treatment regimen is supposed to be and politely keep on top of the nursing staff to ensure that it's implemented. Hospitals generally are under-staffed and the nurses forget to do stuff when it's supposed to be done, and in my case actually prepped me for and asked me to sign consent to the wrong operation. Be very nice to the nurses, but don't be passive.

5. Operate on the principle of informed consent and ask questions if information isn't volunteered. Seems that a lot of docs forget that they're not vets. Don't consent to anything until the pros and cons have been explained to you and then you make the decision. With meds you're likely to get little more than "take this". Go ahead and take the first dose, but ask for an explanation, and ask for a copy of the med insert from pharmacy or manufacturer's info from the 'net to be provided to you so you can decide whether or not to take your second and subsequent doses. My horror story was being given Amiodarone without any explanation of the potential side effects - and it has a wide and weird variety. At the same time, bear in mind that med inserts could convince you that aspirin is a deadly poison if you didn't keep the info in perspective.

[KMB]

Thanks Barry - I know there are a bunch of us who need as much info before surgery as possible from y'all who have gone through this before.

[Karlynn]

5. Operate on the principle of informed consent and ask questions if information isn't volunteered. Seems that a lot of docs forget that they're not vets.

My animals have had vets that talked more than some of the doctors I've had. And from what a friend in the medical school field tells me, some doctors are just would-be vets that couldn't get into veterinary school.

Great idea Barry.

I would also add:

If possible, have a family member or friend with you at all times, or as much as possible, to help oversee your care both for you and with you. Encourage them to ask questions and call attention to things they are concerned about.

[Nancy]

Absolutely second what Karlynn said about having someone there with you at all possible times from the early morning until the late evening. I've been with Joe in the hospital setting so many times, I can't even remember how many. And I've seen some terrific nursing and medical care, and unfortunately also have seen some dreadful nursing and medical care. I'd say that most of it falls somewhere in between. The valve surgery portion of the hospital and the ICU will probably have the best, but once you leave that rarified air, you surely have to watch every little thing.

Make sure the person who is there with you understands something about medical things, and your condition.

I wish I had a list of what to watch out for, but it would be way too long. Just keep an eagle-eye on everything and everyone, not just the nursing staff, but ANYONE who comes into contact with your loved one.

[Barry]

Well, for myself, having a friend or family member there at all times would result in little more than my being friendless or disowned: I am insufferably cranky when I'm not feeling well. In fact, one way I can tell I'm coming down with something is that I start getting grumpy; normally I'm a pretty friendly cheerful fellow. But when not feeling well, people just annoy me; but I do fine if left alone. Sorta like a sick or injured cat. As Marlene Dietrich put it, "I vant to be alone."

When I'm in that state, I can tolerate people for a while, at least be polite, but that's about it. There were any number of times that I had to mentally remind myself that the insufferably annoying person who was visiting me, a person I consider a dear friend, was visiting me as much to meet their needs as to meet mine and that I needed to at least act like I was grateful that they were visiting. Honesty is not necessarily the best policy. [And that's my Hospital Hint for fellow curmudgeons: At least pretend that you're enjoying the visit.]

But, yeah, somebody's got to be watching the shop, and if you can't do it yourself you need to get someone to watch out for you.

[Nancy]

If you can be sufficiently cranky to do it yourself, it's a good thing. :) Many people having thoracic surgery are quite out of it from left over anesthesia and medications.

When I'm talking about having someone there, I'm not talking about a "visitor" friendly type. I'm talking about a very proactive advocate who will make it their job to watch out while the surgical person rests.

[KAJ]

When you or a family member asks about results from various tests such as x-rays, echocardiograms or whatever, do not take "fine" for an answer. Ask for specifics. If that does not work, demand specifics. My surgeon left for vacation a few days after my surgery. I had no problem with that. His resident saw me the rest of the time. I obivously had a great deal of fluid build-up due to swelling in arms, legs and ankles. The resident just said the x-ray was "fine" with no further explanation. The next day I went home and 24 hours later, was taken by rescue to a local hospital. I strongly suspect the x-ray was not fine because I went into congestive heart failure and was in the hospital for 9 more days. The x-rays at that hospital showed fluid in my lungs.

Another suggestion, make sure a family member brings money so they can buy you food that is really ediable and not the unfit for animal consumption food some hopsitals try to feed you. Of course make sure your doctor will allow you to have "real food" to eat. I was rather fortunate, the 2nd hospital I was in honestly had good food :) . I was shocked since the first hospital I was in was a major heart hospital and the food was definitely unfit for animal consumption :mad: . I complained but saw no improvement.


Karl

[Granbonny]

I think that most people who have OHS..are no where near their hometown.. Most are away in larger hospitals..so no need to worry about friends dropping in...... :p But, I strongly agree that one must have a family member with them 24/7....My Hubby and daughter rented a Motel room across from hospital. Daughter stayed at night..knowing Daddy would probably sleep thru Nurse's coming in, ect. :p Daughter was so important to me..Getting me up right away and making me walk the halls, ect...T.V...radio? I don't ever remember looking at either...Just walking, napping, ect. NO eating ..YIKES...Food tast Yucky..Just drink juice, ect. She also made sure that I was groomed...If you look good, you feel good. :D I remember after 3 days she got upset for the many blood, vein draws....I could have cared less, I was on Happy Juice. :D Plus, I needed her to help take off those dumb stockings to replace with clean ones. :D Still laugh about them..it was the only thing my Insurance charged me for. :D $40.00....and they paid out $90,000.00..that year. :p Bonnie

[Diane]

I agree with needing someone to bring you edible food. After my OHS, I didn't feel like eating very much but what I did eat was certainly NOT what the hospital served me! It got to the point that the dietary person said "well, lets see what you won't eat today" when they brought my tray in. I would eat a few bites from the breakfast trays, but I wouldn't touch anything on the lunch and dinner trays except once there was a piece of angel food cake that I ate. I was fortunate to have my mother there to bring me something edible to eat. She knew I couldn't get strong if I didn't eat. She happens to be a retired RN so she was pretty familiar with what was appropriate to bring me and she also knew what I LIKED and WOULD eat out of those things. She mostly brought me fruit and ice cream. I had also had her bring a few of my favorite sodas and some juice which the nurses labeled and put in the refrigerator for me and I could have them anytime I wanted.

Diane

[BionicRedneck]

I think everyone should have a 6ft wand quadruple cell cattle prod laid under the covers next to them at all times. This thing would come in handy when that nurse seems to think its funny to wake you up at 4 a.m. for your bp, pulse, and temp. Then when you prod her is when she comes back in at 5 a.m. to weigh you. It wouldnt take but a zap or 2 and she would weigh you when she does everything else.

I took my laptop, xbox, and all other kinds of crap. I found that most days I didnt feel like entertaining myself more than laying in the bed thinking or talking. The other days i was disgruntled cause I felt good enough to go home and wasnt able too. After about day 10-12 of my 4-6 stay, I kind of lost interest in everything and started walking the halls getting the number of steps to the elevator and the floor plan memorized for my midnight break. At day 18 I had figured out who was conspiring against me and just telling me what I wanted to hear, so all I did was mainly lay in the bed, didnt talk much, didnt watch tv, or listen to the radio. BUT, on the other hand those 18 days appear and seem like a drugged up haze and alot of congnitive recollection is not there. Amazing what your remember and what you dont.

[ALCapshaw2]

When you or a family member asks about results from various tests such as x-rays, echocardiograms or whatever, do not take "fine" for an answer. Ask for specifics. If that does not work, demand specifics. My surgeon left for vacation a few days after my surgery. I had no problem with that. His resident saw me the rest of the time. I obivously had a great deal of fluid build-up due to swelling in arms, legs and ankles. The resident just said the x-ray was "fine" with no further explanation. The next day I went home and 24 hours later, was taken by rescue to a local hospital. I strongly suspect the x-ray was not fine because I went into congestive heart failure and was in the hospital for 9 more days. The x-rays at that hospital showed fluid in my lungs.

Another suggestion, make sure a family member brings money so they can buy you food that is really ediable and not the unfit for animal consumption food some hopsitals try to feed you. Of course make sure your doctor will allow you to have "real food" to eat. I was rather fortunate, the 2nd hospital I was in honestly had good food :) . I was shocked since the first hospital I was in was a major heart hospital and the food was definitely unfit for animal consumption :mad: . I complained but saw no improvement.


Karl

Karl - Which hospital had the "good food" and which had the unedible food?

Also, which hospital let you go home with CHF?

'AL Capshaw'

[KAJ]

AL,

UAB had the unedible food. Baptist Hospital South in Jacksonville had the good food. As it worked out, I was in the hospital longer at Baptist than at UAB. That worked out to my benefit or I probably would have starved to death ;).

Karl




Karl - Which hospital had the "good food" and which had the unedible food?

Also, which hospital let you go home with CHF?

'AL Capshaw'

[gadgetman]

Karl,

As a fellow alumni of UAB I can attest to the lously food. That was my only complaint while there (other than the every two hour visits :mad: by nurses). Also sorry you experienced what you did while there. My staff was very thorough in their minute by minute check :mad: :mad: , even once increasing the lasix when they noticed my legs had become swollen. My wife was my advocate while there, questioning everything they did or wanted to do to me. I thought she might get thrown out several times.

As for Barry's original post, I had all those things lined up to take with me to admitting. The wife had even bought a DVD player and 10-12 movies to keep me occupied. Unfortunatly, I was admitted direct to ICU three days earlier than planned. I really didn't feel like doing all those things. Just getting through this was number one on my list while in ICU :eek: .

And as far as the "side thread" of bringing in outside food. Make SURE you check with the staff BEFORE. When I was trying to find something edible in that stuff they put on the plate, we asked them if I could have something brought in. The Nurses and Doctor said because I was being monitored for my intake/output they recommended against it. Any sudden weight gain would normally signify retaining fluids and outside food (real edible FOOD) might cause a false warning sign. They were nice and brought me several "snack" items (hospital approved of course).

As BionicRedneck pointed out, from all the second-by-second visits :mad: :mad: :mad: I don't think I could have enjoyed any outside entertainment.

May God Bless,

Danny

[Barry]

I am forever grateful to my mother for having been such an abyssmal cook. I grew up on food-like substances generally boiled or fried into submission, don't know that I saw a recognizable vegetable until boot camp. I thought the hospital food was OK, just kinda bland - but then, I liked Army chow!

I think arguably the most imporant thing to bring with you is a rather demented sense of humor.

[kcpub]

I have been reading through all these "pre-surgery" posts (thank you all!), as my husband will be going in on Tues 4/26 for a cath and Wed 4/27 for an AVR. He is 43 and quite nervous about it all (as can be expected). A lot to take in in 2 weeks (we just found out 2 weeks ago that he needs the surgery). At any rate, I am trying to gather up as much info as I can in this short time. Anything else to add to my accumulated list?! Thanks in advance, KC

1. Befriend the housekeeping staff or find out where they stash the linens and get yourself a robe. Been in three hospitals, all three had robes, none of the three offered me one. Having a robe to wear over your hospital gown does much for the dignity factor.

2. Pay very close attention to what your treatment regimen is supposed to be and politely keep on top of the nursing staff to ensure that it's implemented. Hospitals generally are under-staffed and the nurses forget to do stuff when it's supposed to be done, and in my case actually prepped me for and asked me to sign consent to the wrong operation. Be very nice to the nurses, but don't be passive.

3. Operate on the principle of informed consent and ask questions if information isn't volunteered. Seems that a lot of docs forget that they're not vets. Don't consent to anything until the pros and cons have been explained to you and then you make the decision. With meds you're likely to get little more than "take this". Go ahead and take the first dose, but ask for an explanation, and ask for a copy of the med insert from pharmacy or manufacturer's info from the 'net to be provided to you so you can decide whether or not to take your second and subsequent doses. My horror story was being given Amiodarone without any explanation of the potential side effects - and it has a wide and weird variety. At the same time, bear in mind that med inserts could convince you that aspirin is a deadly poison if you didn't keep the info in perspective.

4. If possible, have a family member or friend with you at all times, or as much as possible, to help oversee your care both for you and with you. Encourage them to ask questions and call attention to things they are concerned about.

5. If possible, have a family member or friend with you at all times, or as much as possible, to help oversee your care both for you and with you. Encourage them to ask questions and call attention to things they are concerned about. I'm talking about a very proactive advocate who will make it their job to watch out while the surgical person rests.

6. When you or a family member asks about results from various tests such as x-rays, echocardiograms or whatever, do not take "fine" for an answer. Ask for specifics. If that does not work, demand specifics.

7. Another suggestion, make sure a family member brings money so they can buy you food that is really edible and not the unfit for animal consumption food some hospitals try to feed you. Of course make sure your doctor will allow you to have "real food" to eat.

8. Do yourself a BIG favor and designate one person to tell, who will in turn call the others, I know it might cause some hurt feelings, but you must take care of yourself. You'll be called upon to do heavy duty nursing care when your loved one comes home.

9. And also limit visitors for the first few days at home. Both of you will not be sleeping well at all, and you will have a ton of things to do, up to and including personal care when needed.

10. Bring radio and/or books to add to the post-op TV entertainment.

[Granbonny]

Can we have Hubby's name so we can post him on VR calendar?...The 27th??..We will all be thinking of him. Bonnie

[hayden]

don't leave anything of value in the room when you go walking. My wife had her purse stolen from the room while we were walking......that was the low point of our stay!!

[Debrinha GT]

Thanks Barry for the hints, however, I don't know about how things work in American hospitals, but here in Brazil, doctors and staff don't really let you in on everything that's being done to you. I mean, they explain all about the operation itself, ask and answer questions, but don't really let you take a look at your chart and I don't think the patient's allowed to question on the medicine they're being given and so on. Any hints to try and change that? They say you should never make a doctor or nurse dislike you, after all, you're in their hands and some people even fear getting something bad done to them. Good luck to us!
Débora

[Bionic Man]

Take advantage! Enjoy your time in the hospital which inevitably means asking for food other than what they give you standard. (I kept getting eggs with mushrooms on top) Don't feel shy to ask for something special from the kitchen even if it's late at night. They will often put together a sandwitch or something based on what you want.

If you have to take magnesium powder to stabilize your heartbeat take it mixed in Sprite. (the sugar makes all the difference)

My sister who's a physical therapist told me about the robe thing... that's a good tip.

[geebee]

When I was in the hospital for my second OHS, my blood chemistry was all messed up (potassium, etc.). The doctor was confused about what was happening and found out I wasn't eating. He asked why and I told him the food was inedible. Food that was supposed to be hot was cold, milk was lukewarm (I even got a container that was spoiled), etc. etc. etc.

He went out to the nurses station and asked for all the menus they had from local restaurants that delivered and brought them in (apparently the nurses didn't eat in the cafeteria either). He told the nurses to order anything I wanted from those restaurants. From that day on, my blood chemistry got back to normal. In addition, I never paid for the delivered food. Don't know who did and never asked. I think my guardian angel was on duty that day.

OTOH - 2 hospitals I "frequented" in Northern NJ that had fabulous food - Chilton Memorial in Wayne and Valley Hospital in Ridgewood. Chilton actually had a full menu from which you could order (not just the 1 or choices from a piece of paper). :D :D

[Nancy]

originally posted by Debora, "They say you should never make a doctor or nurse dislike you, after all, you're in their hands and some people even fear getting something bad done to them."

I know this fear exists among patients and their loved ones also. There have been times when I was afraid to leave Joe alone when someone I wasn't too sure of was on duty. It's a very scary feeling.

I say being friendly is the first order of business, and as long as things are going along fine, no reason to be troublesome, however, if there is neglect or unusual "attitude", or downright ineptness, then it's time to make them fearful of you.

NO patient should have to be afraid of anyone taking care of them.

If you don't like whoever is on your case, speak to the Nurse Manager and have them transferred off the case, and make sure the Nurse Manager understands why you feel that way.

[Bionic Valve Tim]

When I was in the hospital for my second OHS, my blood chemistry was all messed up (potassium, etc.). The doctor was confused about what was happening and found out I wasn't eating. He asked why and I told him the food was inedible. Food that was supposed to be hot was cold, milk was lukewarm (I even got a container that was spoiled), etc. etc. etc.

He went out to the nursesstation and asked for all the menus they had from local restaurants that delivered and brought them in (apparently the nurses didn't eat in the cafeterian either).
[snip]


Very good point--I completely forgot about that when I was in the hospital. My mom and wife would take turns ferrying food from local restaurants. It was definitely a morale boost, and that's invaluable during the post-OHS experience ;) I think the food at my hospital was better than some of the others I've heard about, but still...

Tim

[skimomck]

All this advice has been wonderful. Lots of things I haven't thought about. This is our second time around but I have learned a lot from all of you. Thanks

[Barry]

Thanks Barry for the hints, however, I don't know about how things work in American hospitals, but here in Brazil, doctors and staff don't really let you in on everything that's being done to you. I mean, they explain all about the operation itself, ask and answer questions, but don't really let you take a look at your chart and I don't think the patient's allowed to question on the medicine they're being given and so on. Any hints to try and change that? They say you should never make a doctor or nurse dislike you, after all, you're in their hands and some people even fear getting something bad done to them. Good luck to us!
Débora

By the way hospital staff here in the USA act, things are no different here in the USA than in Brazil. They don't let you in on what's going on, don't tell you much of anything about the meds they give you other than "Take this.", and don't want you to look at your chart. It's not the law, it's just the way they act - here's a specific example:

When I was in for my OHS I was up in the middle of the night and went for a walk through the corridors. Outside each room was a table with the charts for each patient on it. As I returned to my room, I spotted my chart and began to read it. A nurse came up and told me that I wasn't allowed to read it, that doing so was a violation of HIPAA (the Federal law in the US governing release of medical records). I'm rather familiar with HIPAA and politely but firmly told her that, as a matter of fact, it was a violation of HIPAA if they did not let me read my chart (a true fact), but if she wanted me to submit a written request so they could give me the denial in writing to be introduced into evidence at the civil suit I would be filing for HIPAA violation that was certainly OK with me - buffered with "No offense, I know they haven't seen the wisdom of puttin you in charge of the hospital, but what you're telling me is policy is violation of Federal law." From that point on, I had no difficulties accessing my chart.

I've learned to always ask "Why?" with regard to procedures and to ask about risks, benefits, and alternatives. Same with meds - although with meds I've found that the docs often really don't know that much about them themselves, and pharmacy inserts (info from the manufacturer sent to the pharmacy when they order meds) and pharmacists are much better sources of info; docs generally know only about med benefits, I suspect an artifact of pharmaceutical company salespeople being their primary source of med information for anything developed since the doc got out of medical school.

Here in the USA, I think what drives the veterinary medicine approach to medicine (i.e. not working with or talking with your patients) isn't really callous disregard or dehumanization - I think it's that our healthcare system here is just very overloaded and time is money; to make a living in medicine these days you have to see a zillion patients and you can't see that many if you really take the time with each to do meaningful informed consent. Another thing that drives it is that most patients put up with it.

I've also found, however, that in assertively insisting on answers to questions and upon access to my medical record that it is imperative to be exquisitely polite because - besides simple human decency, civility, and respect for other people - you've got to maintain a relationship with these folks.

[Debrinha GT]

Thanks a lot Nancy and Barry for your advice. Thank God I've been quite lucky so far, and I hope the same happens next time I have my surgery. However, it's better to be safe than sorry so, I will ask them to explain things to me this time.
Débora

[dcpickle]

someone mentioned having one person to notify everyone else about your status, etc. I went to groups.yahoo.com, created my own group, and asked everyone to join the group (or just added them myself); Then one person can send a single email to the group and everyone gets it. Great way to keep many different people informed!

[Wise]

someone mentioned having one person to notify everyone else about your status, etc. I went to groups.yahoo.com, created my own group, and asked everyone to join the group (or just added them myself); Then one person can send a single email to the group and everyone gets it. Great way to keep many different people informed!

And I am glad you created your own group, especially since that's how I eventually found VR.com. If you remember, I found your group while doing a search in yahoo. I joined your group and was referred here by you. Many thanks (as I've already told you, but I really am grateful).

Wise

[Barry]

Don;t know how or what to do about this one but be aware that reactions to morphine can be serious and dangerous..

Reactions to morphine are very idiosyncratic. The nursing staff knows this, or at least should know this, and should keep an eye on you. I have heard any number of instances of folks responding to morphine in a manner not unlike yours - going into a very very unpleasant dream-like state in which the distinction between reality and fantasy can't be distinguished. You're the first I've heard of where the person wasn't so immobilized by the drug that they were capable of actually acting out the delusions/hallucinations, though.

Being a former drug-fiend, IV morphine was the one thing I was looking forward to with OHS. My reaction was truly weird - they could have been giving me saline solution for as much as it affected me. Didn't do a thing. No therapeutic effects, no side-effects. For some reason I responded very well to oral percocet, though.

In the ongoing saga of developing hospital hints and how to deal with being stuck in the hospital with over-worked staff who don't do adequate informed consent, don't keep enough of any eye on you, this is a good example of the need to ask about the effects of drugs. And if the answer is that you can get delusional and hallucinatory, it would be a good idea to ask them to keep an eye on you to see if that happens.

This one would also be a good test: If they don't tell you that folks can have very unpleasant hallucinatory dreamy experiences on morphine, they're either ill-informed or not leveling with you. May or may not be a good idea to confront them on that, but certainly a good idea to make a mental note of that newfound information about your medical care-givers.


Actually, as I think of it, our reactions to drugs-of-abuse generally tend to be idiosyncratic. Some folks do morphine and react like you (unpleasant) or I did (no real effect), others develop an unhealthy appetite for more of the drug. This seems to be generally true of alcohol, tobacco, addictive pharmaceuticals, and street drugs. Some drugs fit us just like a key fits in a lock, others (such as you and I with morphine) leave you wondering just why anyone would want to do this stuff.